Harry Reid Pleasantly Surprises: Includes Public Option In Senate Bill

Angering Republicans who are ironically calling Reid a “partisan bully,” and standing up to both the White House and Olympia Snowe, the Senate Majority Leader included the public option in the senate bill. What can make this work is the opt-out compromise, which will put the onus on red state Republicans to decide they don’t want this coverage, as Josh Marshall explains:

First is the issue of scale. The whole logic of the public option is that you have a big enough pool of people that you have the efficiencies and bargaining power that can hold down prices. This is why reformers have never had much patience with state-based programs or coops. If it’s forty or fifty mini-public options, it pretty much defeats the whole purpose because you don’t have any of the market power that allows you to negotiate favorable pricing. It’s not let a hundred flowers bloom, or fifty as the case may be. You really need one big flower.

It’s certainly a problem that a substantial number of Americans — probably in red states — would lack the public option. But by making it an opt-out rather than an opt-in, you start with a truly national program. That’s the key. The default is everyone is in. Even if you had 1/3 or even, conceivably half the states (or half the total national population in however many states) opt out, you’d still have enough heft to make it have the desired effect. And presumably you’d have by far most of the population in the program.

So that’s the starting point. While it’s not ideal, an opt-out gives you the reality of a public option whereas the other compromises give you things that superficially sound similar but actually don’t accomplish the same purpose.